Shift work and sleep disorder comorbidity tend to go hand in hand

Taking into consideration that shift work has a wide-ranging impact on circadian and sleep functioning, it seems likely that shift work increases the risk of a general sleep disturbance, spread out over a multitude of comorbid sleep disorders. The aim of the present study is to analyze and present the sleep disorder data of 250 shift workers and 971 permanent day workers, taken from a nationally representative sample. Additional data concerning duration, timing, and quality of sleep, daytime functioning and social/family variables were added to the analyses. The results showed that the shift workers experienced significantly more difficulties with the variability of their sleep times, reported more napping and considered themselves more as poor sleepers than the day workers. Most importantly, shift work, in comparison with day work, appeared associated with a significantly higher prevalence of the clinical, International Classification of Sleep Disorders’ defined symptoms of nearly all main sleep disorders (including shift work disorder). For shift workers, the prevalence of a general sleep disturbance was 39.0% (95%CI 33.2 – 45.2), significantly higher than for day workers (24.6%, 95%CI 22.0 – 27.4). Moreover, shift workers were characterized by high levels of sleep disorder comorbidity. In addition, exclusively for shift workers, the prevalence of disordered sleep systematically decreased across decades of life and was considerably higher for single versus partnered shift workers. This study adds to the insight into the interacting factors that determine shift work coping and may play a role in occupational health interventions aimed at reducing sleep problems and thus improving the resilience and tolerance of the shift worker.     

Bright-light exposure during daytime sleeping affects nocturnal melatonin secretion after simulated night work

The guidelines for night and shift workers recommend that after night work, they should sleep in a dark environment during the daytime. However, staying in a dark environment during the daytime reduces nocturnal melatonin secretion and delays its onset. Daytime bright-light exposure after night work is important for melatonin synthesis the subsequent night and for maintaining the circadian rhythms. However, it is not clear whether daytime sleeping after night work should be in a dim- or a bright-light environment for maintaining melatonin secretion. The aim of this study, therefore, was to evaluate the effect of bright-light exposure during daytime sleeping on nocturnal melatonin secretion after simulated night work. Twelve healthy male subjects, aged 24.8 ± 4.6 (mean ± SD), participated in 3-day sessions under two experimental conditions, bright light or dim light, in a random order. On the first day, the subjects entered the experimental room at 16:00 and saliva samples were collected every hour between 18:00 and 00:00 under dim-light conditions. Between 00:00 and 08:00, they participated in tasks that simulated night work. At 10:00 the next morning, they slept for 6 hours under either a bright-light condition (>3000 lx) or a dim-light condition (<50 lx). In the evening, saliva samples were collected as on the first day. The saliva samples were analyzed for melatonin concentration. Activity and sleep times were recorded by a wrist device worn throughout the experiment. In the statistical analysis, the time courses of melatonin concentration were compared between the two conditions by three-way repeated measurements ANOVA (light condition, day and time of day). The change in dim light melatonin onset (ΔDLMO) between the first and second days, and daytime and nocturnal sleep parameters after the simulated night work were compared between the light conditions using paired t-tests. The ANOVA results indicated a significant interaction (light condition and3 day) (p = .006). Post hoc tests indicated that in the dim-light condition, the melatonin concentration was significantly lower on the second day than on the first day (p = .046); however, in the bright-light condition, there was no significant difference in the melatonin concentration between the days (p = .560). There was a significant difference in ΔDLMO between the conditions (p = .015): DLMO after sleeping was advanced by 11.1 ± 17.4 min under bright-light conditions but delayed for 7.2 ± 13.6 min after sleeping under dim-light conditions. No significant differences were found in any sleep parameter. Our study demonstrated that daytime sleeping under bright-light conditions after night work could not reduce late evening melatonin secretion until midnight or delay the phase of melatonin secretion without decreasing the quality of the daytime sleeping. Thus, these results suggested that, to enhance melatonin secretion and to maintain their conventional sleep–wake cycle, after night work, shift workers should sleep during the daytime under bright-light conditions rather than dim-light conditions.     

Circadian gene methylation in rotating-shift nurses: a cross-sectional study

Investigating the methylation status of the circadian genes may contribute to a better understanding of the shift work-related circadian disruption in individuals exposed to artificial light at night. In the present study, we determined the methylation status of the circadian genes associated with a shift work pattern among nurses and midwives participating in a cross-sectional study in Lodz, Poland.

Quantitative methylation polymerase chain reaction assays were used to assess promoter CpG methylation in PER1, PER2, PER3, CRY1, CRY2, BMAL1, CLOCK, and NPAS2 in genomic DNA from whole blood of 347 women having a rotating-shift work schedule and 363 women working days only. The percentage of methylated reference (PMR) was assessed using fluorescent probes for PER1, PER2, PER3, CRY1, and NPAS2, and the percentage of gene methylation, as the methylation index (MI), using two sets of primers for BMAL1, CLOCK, and CRY2.

We tested the possible association between current and lifetime rotating night-shift work characteristics and circadian gene methylation by using proportional odds regression model with blood DNA methylation, categorized into tertiles, and adjusted for age, current smoking status, folate intake and blood collection time. The findings indicated that CpG methylation in PER2 promoter was significantly decreased (P < 0.004) among nurses and midwives currently working rotating shifts, as compared with day-working nurses and midwives. The lower percentage of PER2 methylation was associated with a higher monthly frequency of current night duties (2–7 night shifts, and eight or more night shifts per month) (P = 0.012) and was associated at borderline significance (P = 0.092) with the lifetime duration of shift work (>10 ≤ 20 years and >20 ≤ 43 years of rotating-shift work) among nurses and midwives (N = 710). Moreover, women with a longer lifetime duration of shift work presented a lower status of PER1 methylation (P = 0.040) than did the women with up to 10 years of rotating-shift work. Long lifetime duration of shift work (> 10 years) among current rotating night-shift workers (N = 347) was associated with BMAL1 hypomethylation (P = 0.013).

Among eight of the investigated circadian genes, only PER1, PER2, and BMAL1 showed differential methylation attributable to the rotating-shift work of nurses and midwives. The findings on blood-based DNA methylation in the circadian genes may provide a better insight into the mechanistic principles underlying the possible health effects of night-shift work but these should be verified in further studies recruiting larger populations of shift workers.     

The impact of shift work on eating patterns and self-care strategies utilised by experienced and inexperienced nurses

ABSTRACT

For nurses, shift work is a necessity, required to provide 24-h continuous care for patients. Research posits that fatigue amongst shift-working nurses is associated with inadequate and poorly timed sleep and also strongly influenced by the timing, quality and quantity of food consumed. The aim of this investigation was to examine differences and similarities in the food choices and eating patterns of nurses exposed to different lengths of time in shift work, as a means of understanding how nurses can adapt their eating patterns to better manage fatigue and sleep loss. Qualitative methodology was utilised to study and capture in-depth information about nurses’ daily working lives. A case study approach allowed for the investigation of nurses with limited and extensive experience of shift work. Increased food craving, caffeine consumption and snacking behaviours during night shifts were described by both groups of nurses, as was the inability to drink enough fluids at work. Meal skipping at work, associated with high workload, was detailed more by experienced nurses. Experienced nurses described shopping and preparing home cooked meals in advance to manage food intake and associated fatigue, contrasting with patterns from inexperienced nurses. Experienced nurses recounted drinking alcohol as a way to rest and recover from shift work, unlike their less inexperienced colleagues. These findings indicate organisational and work place issues such as shift work and rostering influence the food choices and eating patterns of shift-working nurses. Experienced nurses, however, draw on a greater range of strategies around diet and eating patterns to minimise these impacts.     

Sleep quality,sleepiness and the influence of workplace breaks: A cross-sectional survey of health-care workers in two US hospitals

ABSTRACT

This study assessed sleep quality, sleepiness and use of workplace break opportunities in 1285 health-care workers via an online questionnaire. Two hospitals were surveyed – one with and one without a fatigue mitigation policy. Across all respondents, 68.9% reported generally taking breaks of at least 30 min and 21.7% had access to a quiet place to rest, with no significant differences between hospitals. The presence of a fatigue mitigation policy was not associated with reduced sleepiness. However, accounting for hospital and shift characteristics, employees with access to a quiet place to rest while on break had significantly lower self-reported sleepiness scores.     

The effect of maternal obesity on self-esteem and body image

Abstract stress, dissatisfaction and the feeling of inadequacy experienced as a result of the change in appearance caused by weight gain affects self -esteem and body image of pregnant women negatively. The aim of this study was to determine the relationship between maternal obesity, self-esteem and body image. The study was performed through a questionnaire in a state hospital in Trabzon, Turkey with 300 unselected pregnant women who were recruited from the delivery unit. As data collection tools, Body Image Scale (BAS) and Coopersmith Self-Esteem Scale (GIS) were used between April and May 2016. According to BMI variables, 12.3%, 57.0% and 30.7% of the pregnant women were normal, overweight and obese respectively and gained an average of 12.11?±?3.03?kg during pregnancy. Accordingly, the majority of pregnant women who participated in this study were found to be overweight and obese. While the body image of pregnant women surveyed in this study was at a high level (158.84?±?21.34), their average self-esteem was found at a moderate level (64.01?±?15.88). Based on BMI, 56.8% of the women with normal weight perceived themselves as normal, 48.0% of overweight women perceived themselves as normal and 53.3% of obese women perceived themselves as overweight. There was a positive significant relationship between participants' body image and their BMI (r?=?0.119 p?<?0.05). The pregnant women with normal BMI were more likely to feel satisfied. While 56.8% of the pregnant women at normal weight based on BMI were found to feel satisfied and 43.3% of those overweight felt satisfied, 54.3% of obese ones did not feel satisfied. A weak positive significant correlation was found between body image and self-esteem (r?=?0.172; p?=?0.003?<?0.05). As the self-esteem increases, body image increases, too. It was found that the majority of pregnant women were overweight and obese according to BMI and their average body image and self-esteem were high and medium level respectively.     

Maternal exercise training attenuates endotoxin-induced sepsis in mice offspring

Regular exercise during pregnancy can prevent offspring from several diseases, such as cardiovascular diseases, obesity, and type II diabetes during adulthood. However, little information is available about whether maternal exercises during pregnancy protect the offspring from infectious diseases, such as sepsis and multiple organ dysfunction syndrome (MODS). This study aimed to investigate whether maternal exercise training protects the offspring from endotoxin-induced septic shock in mice. Female C57BL/6 mice performed voluntary wheel exercises during pregnancy. All dams and offspring were fed normal chow with sedentary activity during lactation and after weaning. At 10-week-old, mice were intraperitoneally injected a lethal (30 mg/kg) or nonlethal (15 mg/kg) dose of lipopolysaccharide (LPS), following which the survival of mice that were administered a lethal dose was monitored for 60 h. Plasma, lung, and liver samples were collected 18 h after the injection to evaluate the cytokine concentration or mRNA expression from those administered a nonlethal dose. Although maternal exercise training could not prevent lethality during an LPS-induced septic shock, it significantly inhibited the LPS-induced loss of body weight in female offspring. Regular maternal exercise significantly inhibited the mRNA expression of the LPS-induced inflammatory cytokines, such as interleukin-1β (IL-1β) and interferon-γ (IFN-γ), in the plasma and liver. Thus, maternal exercise inhibited the LPS-induced inflammatory response in female offspring, suggesting that regular exercise during pregnancy could be a potential candidate of the onset of sepsis and MODS in offspring.     

Oxidative stress induced by prenatal LPS leads to endothelial dysfunction and renal haemodynamic changes through angiotensin II/NADPH oxidase pathway: Prevention by early treatment with α-tocopherol

We investigated whether hypertension induced by maternal lipopolysaccharide (LPS) administration during gestation is linked to peripheral vascular and renal hemodynamic regulation, through angiotensin II?→?NADPH-oxidase signalling, and whether these changes are directly linked to intrauterine oxidative stress. Female Wistar rats were submitted to LPS, in the absence or presence of α-tocopherol during pregnancy. Malondialdehyde in placenta and in livers from dams and foetuses was enhanced by LPS. Tail-cuff systolic blood pressure (tcSBP) was elevated in the 16-week-old LPS offspring. Renal malondialdeyde and protein expression of NADPH oxidase isoform 2 were elevated in these animals at 20?weeks of age. Maternal α-tocopherol treatment prevented the elevation in malondialdehyde induced by LPS on placenta and livers from dams and foetuses, as well as prevented the elevation in tcSBP and the elevation in renal malondialdehyde in adult life. LPS offspring presented impairment of endothelium-dependent relaxation in aorta and mesenteric rings, which was blunted by angiotensin type 1 receptor (AT₁R) blockade and NADPH oxidase inhibition. At age of 32?weeks, renal hemodynamic parameters were unchanged in anaesthetised LPS offspring, but angiotensin II infusion led to an increased glomerular filtration rate paralleled by filtration fraction elevation. The renal haemodynamic changes provoked by angiotensin II was prevented by early treatment with α-tocopherol and by late treatment with NADPH oxidase inhibitor. These results point to oxidative stress as a mediator of offspring hypertension programmed by maternal inflammation and to the angiotensin II?→?NADPH oxidase signalling pathway as accountable for vascular and renal dysfunctions that starts and maintains hypertension.     

Effects of emergence date and maternal size on egg development and sizes of eggs and first-instar nymphs of a semelparous aquatic insect

We examined whether or not sizes of eggs and offspring were related to emergence date or maternal size in a semelparous aquatic insect (the burrowing mayfly, Hexagenia) in which parental care is lacking and oviposited eggs are passively dispersed. We quantified the size of males and female imagos over the emergence span at a site on the Detroit River, Canada, and investigated relationships between emergence date and female size and (1) egg size and (2) size of first-instar nymphs. Although size of female imagos (H. limbata and H. rigida combined) declined significantly (P<0.025) over the emergence season, there was no significant relationship between body length and emergence date for males of either species. Males were significantly (P<0.001) smaller than females. H. limbata eggs, subsampled from three individuals from each of three size classes of female imagos collected on seven sampling dates, were measured using video image analysis. Eggs (n=100) oviposited by each of 63 H. limbata imagos were inspected daily for hatching. Newly hatched nymphs were removed, counted and measured. Egg size (P<0.001) and size of first-instar nymphs (P<0.001) varied significantly with emergence date, but not maternal size. The largest eggs and newly hatched nymphs occurred at peak emergence of adults. The synchronous release of larger (faster-sinking) eggs may result in reduced predation. Plasticity in egg development time and egg and nymph size may account for the ability of this taxon to recover from episodes of massive population reduction. Received: 12 March 1996 / Accepted: 24 February 1997